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The peptides hormonal relevance remains theoretical and based on its effects on upstream factors (inflammation, vascular health, gut integrity) rather than direct HPG axis stimulation

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Vascular lesions include diffuse and spontaneous relapsing petechial purpura, orthostatic acrocyanosis, hemorrhagic suffusions of mesothelial surfaces, and intestinal mucosa associated with chronic hemorrhagic diarrhea [148]

For this reason, people who develop peripheral neuropathy, ataxia, or retinitis pigmentosa (RP) of unknown causes should be screened for vitamin E deficiency (24)